Hopkins Has GI Residency For NPs

[futuredoc15]

From the current edition of the Johns Hopkins Gastroenterology/Hepatology InsideTract throwaway, which talks about Monica VanDongen, who has performed hundreds of colonoscopies in the two years since she began her training and clinical practice in the department... She is a nurse practitioner who completed a one-year, intensive medical fellowship in gastroenterology.The article goes on to tout her 94.6 percent success rate for cecal intubation and her adenoma detection rate of 0.43 per colonoscopy. In addition departmental reviewers are so pleased with the new venture with Hopkins' school of nursing that two more fellows are in training. Her profile here says she is Gastroenterology board
eligible http://www.everydayhealth.com/doctors/dr-monica_l_van_dongen_ba_crnp-21093628

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[futuredoc15]

http://www.hopkins-gi.org/FSP_Fello...1&FSP_ID=A8A22AF1-D5AC-4CEC-8B5B-E334458DFD20

 

[Instatewaiter]

From the current edition of the Johns Hopkins Gastroenterology/Hepatology InsideTract throwaway, which talks about Monica VanDongen, who has performed hundreds of colonoscopies in the two years since she began her training and clinical practice in the department... She is a nurse practitioner who completed a one-year, intensive medical fellowship in gastroenterology.The article goes on to tout her 94.6 percent success rate for cecal intubation and her adenoma detection rate of 0.43 per colonoscopy. In addition departmental reviewers are so pleased with the new venture with Hopkins' school of nursing that two more fellows are in training. Her profile here says she is Gastroenterology board
eligible http://www.everydayhealth.com/doctors/dr-monica_l_van_dongen_ba_crnp-21093628

So I am an IM resident at hopkins. They can say whatever they want to about the NPs involvement in the "fellowship" but they essentially do nothing. During rounds they sit there and say nothing. They were basically shadowing. It is not even close to a real fellowship.

 

[voidlogin]

I was recently at a FP rotation where they teach NP's. After graduation those NP's allowed to do everything a doctor is allowed and even set up their own practice without physician oversight. Pretty soon people are going to start questioning the value of going through med school when you can get an RN during your undergrad then become an NP and do everything a doctor can.

 

[smq123]

Moved to Topics in Healthcare.

 

[justaregularmed]

.

 

[JaggerPlate]

So I am an IM resident at hopkins. They can say whatever they want to about the NPs involvement in the "fellowship" but they essentially do nothing. During rounds they sit there and say nothing. They were basically shadowing. It is not even close to a real fellowship.

Frankly, it makes no difference whether or not the nurses are sitting around watching physicians do scopes all day or if they are flying in like trauma surgeons and scoping hundreds of patients per week ... what matters is that Hopkins is pandering to this bull****.

I understand that it's politics and probably has far more to do with an established nursing program, but the fact of the matter is that NPs now have the ability to run around stating the following: "Dr. Noctor is a GI specialist who completed an intensive fellowship in GI and scoping procedures at the John Hopkins school of Medicine." The average patient is going to see this and feel 100% confident that this "doctor" is a highly specialized, trained expert who trained at one of the most recognizable and respected MEDICAL programs in the country.

Truly a disappointment. Completely myopic and utterly disappointing. I would be insulted if I were an IM trained physician from Hopkins (like yourself) looking into a GI fellowship.

 

[Slack3r]

So I am an IM resident at hopkins. They can say whatever they want to about the NPs involvement in the "fellowship" but they essentially do nothing. During rounds they sit there and say nothing. They were basically shadowing. It is not even close to a real fellowship.

Whether or not that's true, they still get to say GI fellowship trained at Johns Hopkins.

And shocking how NP's are supposed to alleviate primary care shortages, yet you have them in some of the most potentially lucrative fields in medicine: derm and GI.

 

[JaggerPlate]

Whether or not that's true, they still get to say GI fellowship trained at Johns Hopkins.

And shocking how NP's are supposed to alleviate primary care shortages, yet you have them in some of the most potentially lucrative fields in medicine: derm and GI.

Filling that crucial upper GI scope gap in urban Baltimore. God bless these selfless soldiers. Sgt. Mundinger must be so proud.

 

[bucks2010]

Since this program is just 1/3 the length of the MD fellowship, do you think they would really be teaching them procedures? If they are really training them to do scopes in 12 mos whereas it takes MD's 36 mos to do the same -- that is jacked up. I would hope that any state medical board would not allow that.

Also - would these nurses be able to practice independently? I am not sure of the scope limitations. It would be quite worrisome to have a GI practiced comprised solely of nurses, though I am not sure this is allowable under current laws.

 

[deleted6669]

would these nurses be able to practice independently? I am not sure of the scope limitations. It would be quite worrisome to have a GI practiced comprised solely of nurses, though I am not sure this is allowable under current laws.

The more likely scenario is that they would go to work for an md lead GI group doing routine screening exams all day long.
there is an hmo near me with a (md supervised) colorectal clinic staffed by pa's doing colonoscopies all day long.

 

[Instatewaiter]

Frankly, it makes no difference whether or not the nurses are sitting around watching physicians do scopes all day or if they are flying in like trauma surgeons and scoping hundreds of patients per week ... what matters is that Hopkins is pandering to this bull****.

I understand that it's politics and probably has far more to do with an established nursing program, but the fact of the matter is that NPs now have the ability to run around stating the following: "Dr. Noctor is a GI specialist who completed an intensive fellowship in GI and scoping procedures at the John Hopkins school of Medicine." The average patient is going to see this and feel 100% confident that this "doctor" is a highly specialized, trained expert who trained at one of the most recognizable and respected MEDICAL programs in the country.

Truly a disappointment. Completely myopic and utterly disappointing. I would be insulted if I were an IM trained physician from Hopkins (like yourself) looking into a GI fellowship.

I'm not insulted. She is not a real GI doctor. While I agree, doctors will know the truth, the public probably not, which is why it's bull****. It is bull**** they are allowed to do colonoscopies but it sounds like that is all she can do- routine colonoscopies. Ironically, the hard part is the mental part of GI, but it is the procedures that actually pay the money. I agree, it is a slippery slope but a monkey could do a colonoscopy with some training. Hell, at the end of my training I'll be allowed to do colonoscopies by law... not that I would.

 

[Socrates25]

I'm not insulted. She is not a real GI doctor. While I agree, doctors will know the truth, the public probably not, which is why it's bull****. It is bull**** they are allowed to do colonoscopies but it sounds like that is all she can do- routine colonoscopies. Ironically, the hard part is the mental part of GI, but it is the procedures that actually pay the money. I agree, it is a slippery slope but a monkey could do a colonoscopy with some training. Hell, at the end of my training I'll be allowed to do colonoscopies by law... not that I would.

1. This "Dr Nurse" is listed as GI "FACULTY" at Hopkins. That is an outrage in and of itself. Does this "faculty" supervise GI fellows? She should if she's really faculty.

2. The GI faculty at Hopkins are selling out. I want the ****ing name of the GI fellowship director who is collaborating with this nurse practitioner "faculty" who is promoting this nonsense. The Hopkins website is purposefully vague about who the program director is of the "real" adult GI fellowship program.

3. I'm emailing every single one of the GI fellows at Hopkins to get their opinion on sharing the title of GI fellow with a nurse who has 1/3 the training. Who gets their choice of scopes? With a NP as "faculty" I'm sure she has enough clout to push residents out of the way for her stooge nurse to jump in.

4. "it sounds like that is all she can do- routine colonoscopies."

Are you ****ing crazy man? You really think this is going to stop at "routine" colonoscopies? What happens in 10 years when they have "mastered" those, do you really think they are going to sit still on this and not expand to other scopes?

Its time for a scorched earth policy on this. Medicaid/Medicare should eliminate the ability of MDs to bill for NP procedures. Give them their own billing numbers so that the scab MDs like the GI faculty at Hopkins cant get rich off of them anymore. Its the only way to kill this cancer. Lets see what happens when they lose the ability to bill for supervision and the NPs branch off and start their own practice, advertising they can do the scopes for 1/3 the cost of what the GI faculty will do them for. Watch all the insurance companies drop the Hopkins GI faculty and run to this NP GI "specialist" for all their "routine" scopes and then we'll really find out if the faculty dont mind that all their bread/butter stuff got taken away.

 

[Instatewaiter]

1. This "Dr Nurse" is listed as GI "FACULTY" at Hopkins. That is an outrage in and of itself. Does this "faculty" supervise GI fellows? She should if she's really faculty.


2. The GI faculty at Hopkins are selling out. I want the ****ing name of the GI fellowship director who is collaborating with this nurse practitioner "faculty" who is promoting this nonsense. The Hopkins website is purposefully vague about who the program director is of the "real" adult GI fellowship program.

3. I'm emailing every single one of the GI fellows at Hopkins to get their opinion on sharing the title of GI fellow with a nurse who has 1/3 the training. Who gets their choice of scopes? With a NP as "faculty" I'm sure she has enough clout to push residents out of the way for her stooge nurse to jump in.

4. "it sounds like that is all she can do- routine colonoscopies."

Are you ****ing crazy man? You really think this is going to stop at "routine" colonoscopies? What happens in 10 years when they have "mastered" those, do you really think they are going to sit still on this and not expand to other scopes?

Its time for a scorched earth policy on this. Medicaid/Medicare should eliminate the ability of MDs to bill for NP procedures. Give them their own billing numbers so that the scab MDs like the GI faculty at Hopkins cant get rich off of them anymore. Its the only way to kill this cancer. Lets see what happens when they lose the ability to bill for supervision and the NPs branch off and start their own practice, advertising they can do the scopes for 1/3 the cost of what the GI faculty will do them for. Watch all the insurance companies drop the Hopkins GI faculty and run to this NP GI "specialist" for all their "routine" scopes and then we'll really find out if the faculty dont mind that all their bread/butter stuff got taken away.

She is not listed as faculty: http://www.hopkins-gi.org/JHGI_Faculty.aspx?SS=&CurrentUDV=31

I think you guys are over-reacting but contact whomever you want to. It does seem that the website seems to play up her role and the actual clinical experience that NPs get in the "fellowship." What the fellowship really does is prepare an NP for a role as a GI NP, not as a sole provider. I agree though that the website doesn't make that distinction.

 

[Socrates25]

She is not listed as faculty: http://www.hopkins-gi.org/JHGI_Faculty.aspx?SS=&CurrentUDV=31

I think you guys are over-reacting but contact whomever you want to. It does seem that the website seems to play up her role and the actual clinical experience that NPs get in the "fellowship." What the fellowship really does is prepare an NP for a role as a GI NP, not as a sole provider. I agree though that the website doesn't make that distinction.

Sharon Dudley Brown, PhD, FNP is clearly listed under "full time faculty" on the "our physicians" page of their website.

The biggest snake in this is not the NP, its the GI fellowship director who is collaborating with these scoundrels. The NP fellowship cant exist without the GI MD's explicit permission to let these idiots into the colonoscopy suites.

 

[JaggerPlate]

I think you guys are over-reacting

Nope. History has proved this point (with regard to NPs) over and over again. "They will just stay in primary care;" "The CRNA-esque mentality is limited to Anesthesiology ... my field is safe," etc, etc, etc.

This case is no different. I applaud Socrates for being pro-active and protective of his profession

 

[deleted87716]

Sharon Dudley Brown, PhD, FNP is clearly listed under "full time faculty" on the "our physicians" page of their website

So are a bunch of PhDs, one guy with only a BS, and at least a couple of folks with no initials whatsoever after their names. "Faculty" doesn't mean "MD" exclusively at most institutions.

The big GI group in town here uses NPs a lot in their office. Not to do scopes, at least...not yet.

 

[JaggerPlate]

So are a bunch of PhDs, one guy with only a BS, and at least a couple of folks with no initials whatsoever after their names. "Faculty" doesn't mean "MD" exclusively at most institutions.

Yeah, but the PhDs aren't funding biased studies and greasing slimy politicians in an attempt to practice medicine independently without attending medical school.

The big GI group in town here uses NPs a lot in their office. Not to do scopes, at least...not yet.

Not yet ... this is key. Additionally, just because it's not "happening yet," doesn't mean people should blow it off and let it progress.

 

[deleted87716]

Not yet ... this is key. Additionally, just because it's not "happening yet," doesn't mean people should blow it off and let it progress.

[DEVIL'S ADVOCATE] Why not? It should be a lot easier to train somebody how to perform a procedure (screening colonoscopy) than to provide comprehensive care for the undifferentiated patient (primary care). [/DEVIL'S ADVOCATE]

 

[badasshairday]

What is the status one year later?

 

[hereticmnk]

Hmm...
<----- Pharmacist

Is it really that difficult to concede responsibility to another profession. With great power will come great malpractice. It isn't your butt's on the line. If they are under trained and mess up or provide sub-optimal care, its their butts on the line.

I don't agree with this whole calling yourself "doctor" bull**** that some professions (including mine) like to do. But other professions have something to contribute to the field of healthcare. As Blue Dog stated, you don't need to be trained as a physician to do a colonoscopy.

EDIT- Did not realize this was a yr old thread.. I am also interested to know the status of this program.

 

[Poetic Silence]

Hmmm. . . NP's have come a long way. Good for them. I enjoy seeing the nursing profession grow and prove themselves as capable and competent practitioners.

Medicine is a team sport. Quit hogging the ball.

 

[drLexus]

bump?

 

[altap]

bump?

The irony here is that physicians are the ones training these midlevels. This is business, why on earth would you share your business/trade secret (train someone who did not go through the rigors of med school) to another business competitor?